Healthcare Provider Details

I. General information

NPI: 1255806527
Provider Name (Legal Business Name): RACHEL NICOLE RAMOS AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 OVERLAND PLZ
OVERLAND MO
63114-6123
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US

V. Phone/Fax

Practice location:
  • Phone: 314-449-9633
  • Fax: 314-949-3428
Mailing address:
  • Phone: 615-314-5257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2018033942
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: